| NPI | 1538454673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: VA 0401415631) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: NY 056287) |
| Enumeration Date | 2011-06-16 |
| Last Update Date | 2022-06-30 |